1356726681 NPI number — MRS. PATRICIA PERROTTA SODARO RN NP

Table of content: MRS. PATRICIA PERROTTA SODARO RN NP (NPI 1356726681)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356726681 NPI number — MRS. PATRICIA PERROTTA SODARO RN NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SODARO
Provider First Name:
PATRICIA
Provider Middle Name:
PERROTTA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356726681
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/28/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
41607 MARGARITA RD
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
TEMECULA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92591-2984
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-719-3233
Provider Business Mailing Address Fax Number:
951-719-3213

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5480 BUENA VISTA DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRISCO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75034-2255
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-464-5133
Provider Business Practice Location Address Fax Number:
972-292-0301
Provider Enumeration Date:
07/28/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WW0101X , with the licence number:  295731 3533 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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